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Anaclitic and Introjective Personality Distinctions Among Psychotherapy Outpatients

其他書名	Examining Clinical Change Across Baseline and Therapy Phases
出版	University of Tennessee, Knoxville, 2006
URL	http://books.google.com.hk/books?id=NbJpswEACAAJ&hl=&source=gbs_api

註釋S.J. Blatt and colleagues (e.g., Blatt, 1995; Blatt & Blass, 1996; Blatt & Shichman, 1983) have theorized that individuals develop and function along two basic lines -- that of interpersonal relatedness and that of self-definition. These two modes, while moderately-oscillatory across the lifespan, suggest two respective, relatively-fixed, personality configurations -- the anaclitic and the introjective. It is suggested that psychopathology arises when investment in the themes of one's preferred personality configuration become enduringly over-emphasized. Individuals with anaclitic psychopathologies tend to be plagued by feelings of helplessness and weakness, and they tend to have fears of being abandoned; they generally have a depleted sense of self. Individuals with introjective psychopathologies tend to be plagued by feelings of guilt, self-criticism, and inadequacy; they generally have a distorted sense of self. Some individuals struggle with both types of feelings and problems. Previous research, conducted mostly among seriously disturbed inpatients in long-term therapy, with only a few measurements over time, suggests differential responses to treatment as a function of these anaclitic -- introjective distinctions. Uniquely, the present study employs a form of hierarchical modeling, using continuously collected outcome measurements, to examine therapeutic course and outcome in relatively short-term psychotherapy among outpatients. More specifically, it tests a number of hypotheses examining the role of personality configuration in clinical change during baseline as well as therapy phases. Results indicate that duration-of therapy, and therapeutic alliance levels did not differ significantly as a function of personality configuration; pre-treatment level of symptomotology did not differ between anaclitic and mixed-type patients, and was lower among introjective patients -- who as a group reported a symptomotology-level that was subclinical. In the sample as a whole, significant symptom improvement occurred during baseline-phase -- most of which was driven by clear improvement in the anaclitic and mixed-type groups, while attenuated some by the lack of improvement in the introjective group. During therapy-phase, patients as a whole, and by group, did not report any meaningful change in symptomotology. Several possible explanations for this no-therapy-effect phenomenon, as well as study-limitations, are discussed.